ORLANDO, FL — Is falls prevention mainly the responsibility of your community’s care team?

“If it is, that’s a problem,” Lori Atkinson, RN, BSN, CPHRM, CPPS, content manager at medical professional liability insurance company Constellation in Minneapolis, told those attending a Tuesday session at the American Health Care Association / National Center for Assisted Living’s 70th Annual Convention and Expo.

“From the CEO and the administrator — everyone is responsible for preventing falls and looking at what’s going on in the environment, what’s going on with our residents, because they come in contact with them,” she said. “And so every time there’s contact or interaction, that’s time that we can be preventing and looking at risk for falls.”

In addition to helping residents, falls prevention — and injury prevention, since not all falls can be prevented — also could reduce the organizational costs that would come with a malpractice lawsuit against the community or damage to a community’s reputation, Atkinson said.

The AHCA / NCAL session fell on the day before the Senate Special Committee on Aging was scheduled to hold a hearing scheduled to release a report that provides evidence-based recommendations on ways to reduce the risk of falling, after having asked assisted living providers and others for feedback in May. LeadingAge is among the organizations that provided input.

Falls continue to be a big issue in long-term care, accounting for 42% of medical malpractice claims recently examined by Constellation, Atkinson said. Errors in clinical judgment were overwhelmingly associated with the claims, cited in 92% of them. Policies not being followed or not existing (47%) and communication breakdowns (36%) among staff members or between the staff and the resident / family members also were factors. Atkinson shared cases in which hundreds of thousands of dollars, in one case $300,000, were paid out because of these missteps.

Given those facts, Atkinson told McKnight’s Senior Living, the three most important steps a senior living community can take related to falls prevention are: 

  1. Assess the fall risk assessment tools being used by the organization to ensure that it is identifying resident-specific fall risk factors and that the tools are working to predict falls and injuries.
  2. Have a shared decision-making conversation with each resident and key family members about balancing the benefits of mobility and freedom with the resident-specific risks of a fall / fall-related injury. Such conversations help to set expectations and should be part of a larger effort to communicate about various issues with the resident and family, Atkinson said. “Also agree on the plan to reduce the risk of falls and fall-related injuries,” she said.
  3. Invest in care team member professional development, providing education on critical thinking and communication skills using scenario-based learning modules. “Doing so sets up care team members to be successful in the fall reduction program,” Atkinson said. 

Laws and regulations regarding assisted living vary by state, so it’s important for communities to know what their state regulations say about the scope of practice for all care team members, she said.

“Write that scope into their workflow in policies and protocols, making sure to spread fall reduction responsibilities across the entire care team,” she said. The care team, Atkinson added, also should include physical therapy, occupational therapy, pharmacy and other departments and individuals.

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